Laparoscopic pancreaticoduodenectomy for pancreatic head cancer guided by three-dimensional visual technique, 19 cases of report

Abstract

Objective To evaluate the feasibility and clinical value of laparoscopic pancreaticoduodenectomy in the treatment of pancreatic head cancer. Methods From January 2017 to August 2018, clinical data of 19 patients with pancreatic head cancer were retrospectively analyzed, including 11 male cases and 8 female cases, with average age of (54.3±14.2) years ranging from 23 to 79 years. There were 15 cases of pancreatic ductal adenocarcinoma, 2 cases of pancreatic mucinous adenocarcinoma and 2 cases of papillary carcinoma. The localization two-dimensional CT imaging were performed, and the three-dimensional visualization technique were used to reconstruct the two-dimensional CT images. The preoperative evaluation was carried out. The clinical classification and resectability of the patients were evaluated by three-dimensional visualization and the results were compared after surgery. Results All of 19 cases were proved to be pancreatic head carcinoma by surgical exploration. In 19 patients with 3D visual reconstruction, the resectability was assessed as 4 cases of type I, 7 cases of type Ⅱ, 1 case of type Ⅲ, 3 cases of type Ⅳ and 4 cases of type Ⅴ, pancreatic tumor resection were performed in 8 cases, with 2 cases of vascular anatomic variation. 11 cases of suspected lymph nodes. The anatomical relationship of the three-dimensional reconstruction tumor was approximately consistent with surgical exploration. Conclusion Three-dimensional visualization is helpful to evaluate the resectability of pancreatic tumor patients before operation, to determine tumor size, anatomic variation, enlarged lymph nodes, and so on. It is worth popularizing in clinic. Key words: Pancreatic neoplasms; Imaging, three-dimensional; Laparoscopy; Pancreaticoduodenectomy; Risk assessment